I thought I'd post my story in case it's useful for others. I also have a few questions for those that have been through this already.
I am 4 weeks post op tomorrow. I had BSSO and Lefort 1 (2 piece, I think you'd call it), and my two top back molars were removed.
On December 6, I had my surgery. All went very well, according to my surgeon. My time in the Recovery room was excellent. In hindsight, I must've been heavily medicated to be so relaxed and so sleepy

Day 1 the nurse took out the tube that went from my nose to my stomach, after confirming that my stomach was actively digesting any blood that might be dripping into it. He was impressed. (Good for me! Go stomach). Eventually they took away my pain meds from my IV and I was expected to swallow the liquid form. Not very good. They had me on an every-six hours schedule tylenol+advil, which no one bothered to tell me, so I thought they'd forgotten about me. Things started to hurt a lot after about 4 hours and no one came by. Swelling was increasing also. When I went to the bathroom, with help, my nose would drip blood. But in general, it was OK. The dietitian that I'd met with prior to surgery gave me meal plans that included 8 "meals" per day. Crazy I know, but based on this, I felt like they were starving me in the hospital when they only brought me food 3x per day.

The first week was very hard. Yes, I was swollen (although not a lot according to my surgeon. She said I barely bled during surgery and it was so easy for her. TMI!). Yes, I could barely get in air through my nose and my banded teeth and my nose was raw. Yes I was exhausted and could sleep at a moment's notice. However, the real worst part was the pain, which really unexpected. I spent a lot of time on this forum to help myself be prepared but was very unprepared for the pain. I think I'd focused on the (more common) situation of people having only minimal or moderate pain. Mine was more. Even the surgeon seemed a little bit taken aback when I described it. I had to call for refills of codeine and then asked for something stronger. I was taking either tylenol or advil or codeine (and dabbled in morphine) every few hours, on a rotating schedule around the clock, and even then my pain was only knocked down to a 7 or 8 out of 10. Sometimes it didn't feel like the pain medication was doing anything at all. It felt as though I could feel every incision, every cut and it was deep fiery pain that was relentless. Even more, the whole inside of my mouth as though it was covered in blisters or sores (it was not). My tongue, my throat and all through my mouth. My teeth ached. Swallowing food was a trial and the liquid medication was awful and burning. The inside of my mouth, as far as I could tell, was NOT covered in sores. The surgeon described it as neuropathy. She said there were three types of nerve sensations: numbness, tingling/buzzing (not her terms, just my recollection), and pain. My chief complaint was the latter (though I had all three!) and it was not common. She even went so far as to describe remedial actions that could be taken in a few months--anti-epileptics and anti-depressants, which at low doses can address nerve pain. This freaked my out (why not start me on those now! make it go away! what is happening!) but my husband told me after that what he heard is that in the off chance that it does not go away there are ways to address it. So that calmed me a bit. However, this pain was really all very difficult and scary and is my main reason for writing here. I don't want to freak people out but I felt like it would have been easier if I'd been prepared for this a bit better. I'm holding onto the fact that it IS improving and that it WILL continue to get better. My first week was also plagued by migraines, which unfortunately I get very frequently. They were not very well controlled in this first week. So that meant the front of my face was on fire and the whole rest of my head had a migraine. Not at all fun. Much of the time I just sat in place and looked around, with little energy or ability to focus on anything. It gradually got better starting at about day 6.
Currently, I am only taking pain medication rarely during the day. The pain is almost always there but is at a manageable level (2-5 out of 10). At night, I feel it more (5-7) and am still taking about 2 doses of tylenol or advil. I rarely take the codeine anymore. I am using heat packs. It feels nice. Is there anyone out there that can identify with this level of pain at about 4 weeks? Is this "normal" or still well outside the norm?
I feel a lot of stress/tension from my jaw joint. It feels like it's all pulled taut, which makes total sense when I think about it. It's very sensitive to the touch, on the outside. However, even though it makes total sense, I didn't really expect this pulling/tension feeling, either because I didn't pay attention in my random walks through this forum, or didn't see it very often. I've done a bit of super gentle massage but am not sure if it's making a difference.
My teeth hurt as though I've just gotten an adjustment (see "splint" paragraph below--I'm guessing this is the reason). You know that loose-tooth itchy kind of feeling?
I did have a two instances of clenching my teeth or biting in my sleep (in one instance I was dreaming of eating frosted flakes.

But enough about pain.
Unlike most people, I have not lost weight. At most, I've lost a pound or two, but I don't think that counts. I forced myself to eat, and I had the image in my head of 8 meals per day from the dietitian, so I had a high standard to look up to! In the first few weeks it was difficult to eat and I still don't have much appetite. Smoothies and even milk were too acidic. Ensures were thick and gross. Soup was yuck. Everything was bad.


I have a splint wired into my top braces. I sound like I have mouth full of marbles when I talk, but my family is all used to it and I'm not yet back at work so it hasn't mattered too much. Honestly everything else that would've been aggravating has been eclipsed by the pain



I'm still sleeping on my wedge pillow. I don't know what I would've done without it. It's been great. I also use an airline neck pillow (based on a tip from someone on this forum) and it's also been great. I position it so I'm resting my head sideways, but nothing is touching my jaws. I don't think I've even tried laying flat at all. It doesn't sound inviting. How long did you sleep on an incline. Is there anyone out there that was still sleeping on an incline after 4 weeks or later?
Stitches all are healing and they have fallen out. They looked like little insect legs in the sink. I didn't even look at the incisions for the first few weeks. Too sensitive an area and too swollen to really see

In terms of swelling and how I look, I have swelling in the front of my cheeks and my upper lip. There is some swelling in my lower cheeks and along my jawline, but less. I mostly look like a normal person to the casual observer as long as I don't try to talk (what with the splint and all). My nose is different but even my mom can't see it.



I am still brushing with a 0-2 year old toothbrush most of the time. In the beginning I only brushed the front teeth. After about 3 days, I could get a bit further back--outside of teeth only. After about a week I was able to get inside my mouth to brush my long-suffering teeth and gross tongue (I got inside by forcing all the bristles down as they made their way inside, past my teeth as I opened as wide as I could). Based on a tip from someone on this forum, and especially in the beginning, I brushed each tooth with little circles. The normal side to side movement that I would use for brushing seemed too risky for the very sore back of my mouth and hurt my sensitive swollen cheeks. My routine now consists of swishing a few mouthfuls of water to get rid of larger particles, then using Waterpik (low setting), then brushing, then using the Waterpik with the pik pocket attachment to clean the splint, and then rinsing with salt water (I"m all done with the Peridex mouthwash that was prescribed for the first 10 days). I haven't flossed. That's normal, right? When did people start flossing?
I think that is all I have to say. I hope some of you are still reading!

